RE: Prostate-Specific Antigen Screening Trials and Prostate Cancer Deaths: The Androgen Deprivation Connection

We were intrigued to read the article by Haines and Miklos (1) in which they reviewed published data from the three large randomized prostate-specific antigen (PSA) screening trials: Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial, European Randomized Study of Screening for Prostate Cancer (ERSPC), and the Goteborg trial. The authors note “that in both European trials far more patients received hormonal treatment in the control than the screening arm”, with a concomitant “increase in prostate cancer deaths in control patients” (1). The authors thus claim that, instead of PSA screening effectively reducing prostate cancer deaths in the screening arm, androgen deprivation therapy (ADT) given to patients in the control arm increased prostate cancer deaths, calling their hypothesis an “androgen deprivation connection.”